Medical Problems of Prisoners

Summary

Medical problems of prisoners presents findings on state and federal prisoners who reported a current medical problem, a physical or mental impairment, a dental problem, or an injury since admission based on data from the 2004 Survey of Inmates in State and Federal Correctional Facilities. The prevalence of specific medical problems and conditions is also included. The report examines medical problems and other conditions by gender, age, and select background characteristics. NCJ 221740

Highlights

An estimated 44% of state inmates and 39% of federal inmates reported a current medical problem other than a cold or virus.

Selected findings

Characteristics of inmates with medical problems

Female inmates in both state and federal prisons were more likely to report having a current medical problem than male inmates, but were equally likely to report a dental problem. Among both state and federal inmates, females were more than 1 ½ times more likely to report 2 or more current medical problems than male inmates. The percentages of state and federal inmates who reported a medical problem, a dental problem, or having had surgery since admission increased with age.

Among state and federal inmates current medical problems were most commonly reported by those who were homeless in the year before arrest, who used a needle to inject drugs, and who reported receiving government assistance as compared to those who had not been homeless, who had not used a needle to inject drugs, and who did not receive government assistance.

Characteristics of inmates with impairments

Male and female inmates in state and federal prisons were equally likely to report having at least 1 of 6 impairments which include learning, speech, hearing, vision, mobility, or mental impairment. Female inmates (11%) in state prisons were more likely to report a mental impairment than male inmates (6%).

The percentage of state and federal inmates reporting hearing and vision impairments increased with age. Among state inmates reports of having a learning impairment decreased with age. More than a quarter (28%) of state inmates age 24 or younger reported a learning impairment compared to 16% of those 45 or older. The number of impairments reported varied little between inmates 34 years of age or younger and those 35 years of age or older.

Twenty-one percent of state inmates and 16% of federal, reported having only one impairment. Among state inmates, 16% reported having two or more impairments; 8% of federal inmates.

Impairments were most commonly reported among state and federal inmates who were homeless in the year before arrest, who used a needle to inject drugs, and who reported receiving government assistance as compared to those who had not been homeless, who had not used a needle to inject drugs, and who did not receive government assistance.

Characteristics of inmates who reported injuries

State inmates were about 1½ times more likely to report an accidental injury (22%) than a fight-related injury (16%). Federal inmates were more than 2½ times more likely to report an accidental injury (23%) than a fight-related injury (8%). In state prisons, male inmates were more likely than female inmates to be accidentally injured or injured in a fight. Among state inmates, 17% of those age 24 or younger and ages 25-34 reported being injured in a fight compared to 13% of those age 45 or older.

Health assessments and medical services received by inmates

Most state and federal inmates received some type of medical services either at admission or since admission to prison. About 9 in 10 state and federal inmates reported that at the time of admission they were asked about their health or medical history. About three-quarters reported that staff checked to see if they were sick, injured, or intoxicated at the time they were admitted. Nearly all state (88%) and federal (91%) inmates reported that they were asked about thoughts of suicide at admission to prison.

The majority of inmates in state and federal prisons had received a medical exam, blood test, or TB test since admission. More than 7 in 10 state and 8 in 10 federal inmates were tested for HIV since admission.

Among inmates who reported a current medical problem, 70% of state inmates and 76% of federal inmates reported seeing a medical professional. Among inmates admitted to state and federal prisons, about an eighth reported having had surgery.

More than 8 in 10 state and federal inmates who reported a dental problem reported seeing a health care professional. Eighty percent of state inmates and 86% of federal inmates who reported an injury since admission reported seeing a health care professional.

Problems reported and medical services received by female inmates

More than half of female inmates in state (57%) and federal (52%) prisons reported having a current medical problem. About a quarter of female inmates reported one medical problem and another quarter reported multiple problems. Females reported higher percentages of most of the specific types of medical problems than male inmates. Arthritis, asthma, and hypertension were the most commonly reported medical problems among female inmates.

Nearly all females in state (91%) and federal (94%) prisons reported having a medical exam since admission to prison. Among females, 86% of those in state prisons and 78% of those in federal prisons reported receiving a pelvic exam.

Among female prisoners, 4% of state and 3 % of federal inmates said they were pregnant at the time of admission. Of those in state prisons who said they were pregnant at admission, 94% received an obstetric exam. More than half (54%) received some type of pregnancy care.

Methodology

Surveys of Inmates in State and Federal Correctional Facilities, 2004

The Survey of Inmates in State and Federal Correctional Facilities, 2004, is comprised of two separate surveys: one in state adult correctional facilities and one in federal correctional facilities. The surveys provide nationally representative data on state prison inmates and sentenced federal inmates. Both surveys used the same questionnaire and a stratified two-stage sample design where facilities were selected in the first stage and inmates to be interviewed in the second stage. Findings from the 2004 Survey of Inmates in State and Federal Adult Correctional Facilities presented in this summary should not be compared to findings from the 1997 survey due to a redesign of the medical problems and impairment measures.

The state prison sample was selected from a universe of 1,585 facilities that were enumerated in the 2000 Census of State and Federal Correctional Facilities, or had opened between the completion of the Census and April 1, 2003. A total of 287 state prisons participated in the survey; 2 refused, 11 were closed or had no inmates to survey, and 1 was erroneously included in the universe.

The federal prison sample was selected from 148 federal prisons and satellite facilities holding inmates on January 4, 2003. Thirty-nine of the 40 federal prisons selected participated in the survey.

A total of 14,499 inmates in the state facilities were interviewed; 1,653 inmates refused to participate, resulting in a second-stage nonresponse rate of 10.2%. In the federal survey, after the initial sample of inmates, a secondary sample of 1 in 3 drug offenders was selected for participation in the survey. A total of 3,686 inmates in federal facilities were interviewed and 567 refused to participate, for a second-stage nonresponse rate of 13.3%.

The accuracy of the 2004 Survey of Inmates in State and Federal Correctional Facilities depends on sampling and measurement errors. Sampling errors occur by chance because a sample rather than a complete enumeration of the population was conducted.

Measurement error can be attributed to many sources, such as nonresponse, recall difficulties, differences in the interpretation of questions among inmates, and processing
errors.

The sampling error, as measured by an estimated standard error, varies by the size of the estimate and the size of the base population. These standard errors may be used to construct confidence intervals around percentages. For example, the 95-percent confidence interval around the percentage of state inmates who reported a current medical problem is approximately 43.8% plus or minus 1.96 times .73% (or 42.4% to 45.2%).

These standard errors may also be used to test the statistical significance of the difference between two sample statistics by pooling the standard errors of the two sample estimates. For example, the standard error of the difference between male and female state prisoners who had a current medical problem would be 1.37% (or the square root of the sum of the squared standard errors for each group). The 95% confidence interval around the difference would be 1.96% times 1.37% (or 2.69%). Since the difference of 13.8% (56.7% minus 42.9%) is greater than 2.69%, the difference would be considered statistically significant.